An osteocutaneous foot filet flap based on the posterior tibial vessel
s was successfully used to provide tibial coverage in a patient requir
ing a below-knee amputation following a high-voltage electrical injury
. Addition of the calcaneus to the standard foot filet flap provided a
vascularized bone graft that served to both lengthen the tibia and se
cure the flap via a tibial-calcaneal synostosis. The synostosis provid
ed firm anchoring of the flap and allowed for a partial end-bearing, b
elow-knee prosthesis.